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Shots - Health Blog

Pharmacies Inject Convenience Into Flu Shot Market

Three years ago, drugstores like Walgreens began training pharmacists to give customers vaccines. Since then, tens of thousands of pharmacists have been certified to give shots.

Francis Ying for Kaiser Health News/NPR

Drugstore and supermarket pharmacies across the country have launched a marketing blitz to attract flu shot customers, touting the convenience of stopping at a local drugstore and often offering drop-in vaccinations anytime the pharmacy is open — sometimes even 24 hours a day.

"If you decided at 4 o'clock in the morning you wanted to go out and had nothing better to do than get a flu shot, you could walk right in and you could get a flu shot," says Scott Gershman, pharmacy manager at a Walgreens drugstore in Springfield, Va.

Shelley Troff and her 13-year-old son dropped by Gershman's pharmacy one afternoon in September to get their annual shots. Troff says she didn't even consider going to her doctor's office. "To be frankly honest, Walgreens is easier," she explains. "Since this is one mile from my house and the clinic is 20 minutes from my house, this is where I come."

Pharmacies usually charge between $25 and $32, while a shot at the doctor's office generally costs at least $48, according to Matthew Davis, a pediatrician and associate professor at the University of Michigan in Ann Arbor. But for most people with insurance, it's really about convenience. That's because the shots are generally paid for by insurance.

Under the Affordable Care Act enacted in 2010, most insurers can no longer charge copays for preventive care, including flu shots. Some plans are exempt from that because they were grandfathered under the law.

The majority of Americans still get their flu shot at the doctor's office, but an increasing number head to the pharmacy. In 2010, 18.4 percent of adults who were immunized received the flu vaccine at a supermarket or drugstore, just edging out workplace vaccinations for the second most popular venue, according to the U.S. Centers for Disease Control and Prevention.

The H1N1 epidemic in 2009 helped propel the trend; the panic sent customers running to drugstores, which often had vaccines available after physicians' offices had run out. "It became clear to the government and Americans that pharmacies can provide easy access to vaccines," says Edith Rosato, senior vice president of the National Association of Chain Drug Stores.

But while more people are going to the pharmacy, the number of Americans who get the flu vaccine each year has remained fairly constant at about 40 percent of all adults.

Drugstores and supermarket pharmacies are eager to stake out a bigger piece of that market. Nationwide, the number of pharmacists trained to deliver vaccines has nearly quadrupled since 2007, from 40,000 to 150,000.

It is not clear how profitable the flu shot is to pharmacies, and experts' views on this differ. Revenue figures are proprietary, but Katherine Harris, a senior economist at the Rand Group who studies the vaccine market, says flu shots are not usually a big money-maker. They often involve taking time away from other duties to educate patients and bill insurers, she explains. Other analysts believe drugstores earn profits of 30 to 50 percent on the procedures, the Wall Street Journalreports.

But getting the flu vaccine at a pharmacy might not be right for everyone, particularly patients with chronic illnesses or for the uninsured. "If you're uninsured, go shopping," says Davis. He says the uninsured can often find a cheaper option at their local health department. The vaccine may even be free.

INSKEEP: First, the business of flu shots. It seems that everywhere you go this year - drug stores, supermarkets, even stores like Costco - somebody's trying to sell you a flu vaccination. Customers can pop in anytime for an injection and even get discounts or gift cards as a reward for getting the shot. But getting the vaccine at a pharmacy might not be right for everybody. Jenny Gold of our partner Kaiser Health News has more.

JENNY GOLD, BYLINE: I'm standing in front of the Walgreens in Springfield, Virginia. And in front of the store there is a giant sign that reads Flu Shots. Walk in anytime.

SCOTT GERSHMAN: Welcome to my pharmacy. Thank you guys for coming in.

GOLD: Pharmacy manager Scott Gershman is a round-faced man in his 30s with wireless glasses and a warm smile. For most his 10 years at Walgreens, he's been behind the counter, filling prescriptions and giving advice.

But three years ago, drug stores began training pharmacists like Gershman to give customers vaccines too. Today, he's one of 150,000 pharmacists across the country certified to vaccinate customers. That's nearly four times the number that could do it in 2007. Some pharmacies even offer the shots 24 hours a day.

GERSHMAN: If you decided at 4:00 in the morning you wanted to go out and had nothing better to do than get a flu shot, you could walk right in and you could get a flu shot at 4:00 in the morning.

GOLD: It's hard to argue with the convenience. Stores can usually bill insurers directly for the flu shot, which costs between 25 and 32 dollars. They offer several types of the vaccine, including nasal spray for kids and a special shot for seniors that creates a stronger immune response. For many customers, like Shelley Troff and her son Drew, there's no co-pay. Troff says she didn't even consider going to her doctor instead.

SHELLY TROFF: To be frankly honest, Walgreens is easier. Since this is one mile from my house and the clinic is 20 minutes from my house, this is where I come.

GERSHMAN: Warm up the syringe a little bit.

GOLD: Pharmacy flu shots really started taking off during the H1N1 panic in 2009, when drugstores and supermarkets became a popular place to get vaccinated. And while most Americans still get their flu shot at the doctor's office, 20 percent went to a pharmacy last year instead. The stores see the vaccine as an important area of growth.

EDITH ROSATO: Everyone is trying to drive customers into their store, to get their flu vaccine and then hopefully build customer loyalty and get them to buy other things in the store.

GOLD: That's Edith Rosato of the National Association of Chain Drug Stores. She says flu shots are an opportunity for pharmacies and the public.

ROSATO: Certainly with the shortage of primary care physicians and other health care professionals, we do see the role of the pharmacist as really taking on more responsibility in the health care delivery system.

GOLD: Doctors don't seem to be pushing back about the safety of pharmacists giving the flu vaccine. Some are even grateful to give up a service that tends to take a lot of staff time but isn't particularly lucrative. But pediatrician and University of Michigan Professor Matt Davis has some concerns, especially for patients who only go to the doctor once a year to get their flu shots.

MATT DAVIS: The main concern about pharmacy-based vaccination is that it might somehow discourage patients from otherwise following up with their doctors.

GOLD: He also advises people with chronic illnesses to stick with their doctor, so they can be tracked as carefully and consistently as possible. And as for the uninsured, Davis suggests they head to the county health clinic instead, where the flu shot might even be free.